Eating a Vegetarian Diet. Not As Healthy As You May Believe.

You hear vegetarian and what comes to mind? A nutritious, disease preventing, high fiber diet? Wholesome meals full of whole grains, nuts and seeds, fruits and vegetables, chock full of vitamins and minerals? Slim and fit individuals living a healthy lifestyle, carefully meeting their nutritional needs?

If only it were so! Perhaps in its ideal form this diet is filled with all the protein, healthy fats and unprocessed carbohydrate you might need to stay healthy. It also provides a full range of antioxidants, including flavonoids, found in color-rich fruits and vegetables, as well as in nuts. These compounds are linked with prevention of many cancers, heart disease and aging related conditions. And if you include three low fat dairy servings per day, the model vegetarian diet satisfies the DASH diet for hypertension. This fruit and vegetable filled diet, together with the mineral-rich low fat dairy has been shown in studies to significantly improve blood pressure as effectively as medication.

But in practice, that’s just not how it is. Twenty-five years of counseling clients has shown me how real people live as vegetarians. And it’s not pretty. Here’s a look at what really happens to many vegetarians. Check out these pitfalls to healthy vegetarianism to be sure to avoid.

Vegetarians may set too many unnecessary rules.

Instead of eating the healthy diet described above, they may limit their fats, failing to meet their needs for essential fatty acids. Reduced fat soy milk or lower fat avocado—are they really necessary? Why choose such items?

Being fat phobic, they may omit valuable food sources such as nuts and nut butters, such as peanut butter and almond butter, eggs and even avocado. As a result of this extra layer of rules, it may be challenging to maintain their weight in a healthy range. With their limited selection, they also exclude valuable sources of protein-rich foods.

These vegetarians typically are not yet diagnosable as eating disordered. For them, vegetarianism is simply another way to limit their intake in a socially acceptable way. Vegetarianism is healthy, right?

They have no interest in exploring unfamiliar vegetarian food choices.

And so they limit their intake to vegetarian meals such as pasta, grilled cheese, and pizza, for instance. Now don’t get me wrong. There’s no problem with including these foods, as part of a balanced diet. But vegetarian choices tend to be limited, particularly when eating out. And if you don’t include much variety, the calorie density of your diet can become quite high. This becomes more exaggerated when you don’t care for many fruits and vegetables. And so your entrée portion needs to be larger to feel satisfied. Typically, these individuals end up gaining weight unexpectedly, in spite of their good intentions to eat a “healthy” vegetarian diet. As a result, they are left with a less than balanced diet and are struggling with their weight.

They are cooking challenged or have little time for food preparation.

As a result, they rely on mostly processed foods, generally quite high in sodium. Take a look at the labels on the canned beans or refried beans. Explore the sodium levels of the many soy-based and Quorn brand processed vegetarian products. To achieve the equivalent of three ounces of animal protein (a deck of cards size), you’d consume approximately 1200 mgs of sodium, from this single protein alternative, in a reasonable portion. If you are choosing vegetarianism for the prevention of heart disease, you may want to rethink this choice. If you have high blood pressure, the current recommendation is for a total of 1500 mgs. per day! You’d be better off allowing for lean protein sources such as white meat poultry, or fish, for the pescetarians.

If your nutrient needs are high (if you are still growing, quite active, very tall, pregnant or nursing, or underweight), vegetarianism can be challenging.  

A healthy vegetarian diet, high in whole grains, fruits, vegetables and legumes is high volume, high fiber with low caloric-density. As a result, it can be very filling. If you are someone with a high calorie requirement (like those described above), it takes more effort to meet your needs, while still feeling physically comfortable. It is certainly achievable, but requires a higher intake of fats and a bit more planning. Otherwise, you’ll frequently feel full and have a difficult time consuming all that your body requires.

Oh no! My daughter has decided to become a vegetarian!

Mrs. Katz called me earlier this week, seemingly alarmed, given the tone of her voice on the phone. She just discovered that her daughter has been limiting her eating to vegetarian choices for the past 3 weeks. Rebecca was well known to me from more than a year of regular visits for her eating disorder. Last time I saw her, 6 weeks ago, she had been doing great. She had been maintaining her weight in a health range, without symptoms, and appeared quite relaxed and comfortable about the changes she had made. She was allowing herself a full range of foods, including items formally considered junk foods. And she achieved all this while competing on her high school swim team. For many, many, months now, I could say she had fully recovered.

Mrs. Katz had good reason to contact me. News of her daughter’s becoming vegetarian needed to be explored, to ensure it was not a slip into more eating disordered thinking and behavior.

When I met with Rebecca today, here’s what I concluded. That Mrs. Katz has no need for concern. That while a vegetarian diet could red flag unnecessary dietary restriction, for Rebecca I felt assured that limiting her intake was not the goal (or likely to result from her new found vegetarian identity). Yes, she would have to be mindful to maximize her iron intake, as well as her protein, calcium and Vitamin D, nutrients which often fall short when eating vegetarian. Not being a vegan, B12 deficiency was not going to be an issue. She was eating a varied diet providing enough calories to adequately fuel her body. And her weight continued to be maintained in a healthy range for her height. So it was easy to reassure Mrs. Katz.

Just because some vegetarians may be restrictive eaters, that’s not to say that you can’t be a healthy vegetarian and successfully meet your nutritional needs.

If you’re motivated to be a healthy vegetarian consider the following:

•     A balanced vegetarian diet requires planning. Actually, you can say the same thing for balanced eating of any type. But it is easier to throw a steak on the grill than to cook rice and dry beans.
•     Take advantage of vegetarian resources. Explore the many vegetarian cookbooks and websites for easy, delicious recipes. (Check out some of my favorites on this blog—lentil stew, lentil soup, vegetarian chili and corn bread, granola to name a few. As for cookbooks, my old favorites are Mollie Katzen’s updated Moosewood and The Enchanted Broccoli Forest, as well as the Vegetarian Epicure by Anna Thomas.
•     Eating out? Consider Indian resturants, and other Asian cuisines (offering tofu based vegetable filled dishes), which typically offer a large selection of vegetarian options.
•     Cook soups, stews, and casseroles and freeze them in small batches to provide quick and convenient vegetarian meals.

Being vegetarian clearly has its merits. It makes us more mindful of where our food comes from and its impact on the environment. (For true enlightenment, check out the movie Food, Inc. with Michael Pollan or his books including The Omnivore’s Dilemma). But choosing vegetarianism means not just being morally responsible. It requires being responsible for meeting your body’s needs. And that is equally important.

Do you have a favorite vegetarian cookbook or website? Have a thought to share on this post as a vegetarian or a soon-to-be vegetarian? Please share! I’d love to hear from you.